maternal and childcare

maternal and childcare

Monica is a 38-year-old African American woman, G2/T0P0A2L0. Her first pregnancy ended in a first-trimester therapeutic abortion. She
was unaware that she was pregnant because of her history of heavy and irregular menses. Monica’s second pregnancy ended in a fetal
demise at 18 weeks. She has a new boyfriend. She met him at work; she works as a radiology technician, and he works in facility
maintenance. She has not been using any method of contraception because she thought her risk of pregnancy was less due to her
menstrual irregularity. She worries about hormones causing weight gain. She currently has hypertension and hyperlipidemia, and her body
mass index is 38. She was adopted and is unaware of her biological parents’ genetic risk history. Her internal medicine provider started her
on an ACE inhibitor to control her hypertension and a statin to improve her lipid profile. She is a nonsmoker.
1. Discuss the known preconception health risks of hypertension, hyperlipidemia, and obesity that Monica has, make sure to note how
to reduce these risks.
2. Discuss which medication used to treat hypertension and/or cardiovascular disease has the lowest risk profile and, therefore, would
be considered the safest if an unintended pregnancy were to occur?
3. As Monica does not know her biological family’s genetic risk history, what primary genetic risk factor based on her race or ethnicity
would you most want to screen her for during preconception and why?
4. What other preconception health strategies would you recommend for Monica since she is not actively planning a pregnancy now?

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